To smoke or not to smoke

Catherine Mwauyakufa, CNS Correspondent, ZimbabweThe global economic cost related to tobacco consumption is unknown but it is likely over US$1 trillion annually, as per the Tobacco Atlas 2015.Tobacco users underestimate the harm caused to their health and are many times not even aware of these dangers. I have come across persons with a deep cough and shortness of breath and at the same time holding a cigarette in one hand.
On asking why they keep smoking the answers are baffling—“I have smoked for decades and this cough and shortness for breath is only two months old; so it cannot be due to smoking”; or “I have been smoking since even before you were born,” are the staple answers I have got from tobacco consumers. The chances of a smoker to get lung cancer are 23 times more than that for a non smoker. One in five cancer deaths is due to lung cancer and smoking is the top risk factor for it--- a not so sobering statistic. There seems to be a lack of enough awareness to the dangers of tobacco consumption as these risks to one’s health do not appear overnight. Started in 1988 by the World Health Organisation (WHO) in 1988, the World No Tobacco Day is observed on 31 May every year to highlight the dangers and devastating impact of tobacco use on health, as well as to advocate for policies that help people quit tobacco and keep non smokers away.

The theme for 2016 is “Get ready for plain packaging”

Many people have suffered and died from lung cancer and other tobacco related diseases as a result of smoking and there is also a large number of those who, though never puffed a cigarette in their lives, but suffered the consequences of second hand smoke. The danger caused by passive smoking is high and smoking in public places has been banned in many countries. However, in my home country Zimbabwe it is not unusual to find someone smoking in a bus and they argue that they are blowing the smoke out through the window. There is no effective legislation to tie down those found smoking in public places in Zimbabwe and so effective action lags behind commitment. It is argued that developing nations depend on the income gained from tobacco farming and sale of tobacco products. But the benefits of tobacco sale on gross domestic product are far outweighed by the burden on the healthcare that tobacco consumers face. Healthcare costs keep escalating and in case of Zimbabwe the cancer burden on health delivery keeps ballooning. Some of the cancers are avoidable, so it is high time that this highlighted.

Ways to lessen tobacco use have to be made. Taxing tobacco heavily can be an effective way to reduce consumption and healthcare costs and at the same time presenting a revenue stream for the developing countries. Plain or standardised packaging with graphic health warnings is another way to not only make tobacco products less attractive, but also inform the users of negative health effects of tobacco consumption. We should not overlook the power of advertising, which tobacco companies have used for their benefit, and at the cost of many human lives. They have misled their clients by using attractive words such as ‘low’, ‘mild’, ‘smoking pleasure’. By advocating for plain packaging the pull factor to buy is lessened and the dangers are highlighted. So the campaign ‘to buy or not to buy’ can gain steam as a consumer has the power to decide as long as they are aware of the harm posed to their health by tobacco use.

Charles Sipindi who survived lung cancer said in an interview that he only came to know of the dangers of tobacco use when he was lying in a hospital unable to pay the costs. “I started smoking in high school as it was fashionable to do so. To say that someone ever highlighted the dangers to my health, I do not remember. It was the in thing to be smoking and by the time I was 50 years old I had smoked for 35 years. I was diagnosed with lung cancer and only then did I realise that the ‘smoking pleasure’ was non-existent as I struggled even with basic breathing. I was lucky that my son had started working so he paid for my medical bills which were beyond reach. I had to have an operation followed by chemotherapy and radiotherapy for over a year. The suffering far outweighed the pleasure which I now know is a mirage,” said Sipindi.

Sipindi, who is a teacher, said that he finds it opportune that all students who pass through him know the harms caused by tobacco use. “I tell my students that there is nothing beneficial in smoking except putting a strain on your health. I spent a year in and out of hospital so I do not wish that on anyone. You maybe not be as lucky as I was to survive. So if this type of cancer is avoidable why not skirt it altogether,” said Sipindi. Sipindi said effective pack warnings can see smokers quitting if the risk is highlighted and far outweighs the gains. “A pack must read ‘smoking is harmful to your own health and do so at your own risk’. Rather we find ads put up by tobacco companies reading ‘smoking is a pleasure’, while some show pretty girls hanging around a smoking man. This is misleading and wrong,” said Sipindi.

Yvona Tous, of the Policy Framework Convention Alliance (FCA) for Tobacco Control said that if we are to reduce by one third, premature mortality from non-communicable diseases (NCDs) by 2030 (as envisaged in the post 2015 development agenda) then we have to drum up the tobacco control strategy to prevent avoidable deaths. Some countries which have implemented the plain packaging strategy have now realised the gains of doing so. After Australia took the lead in December 2012, smoking rates in the country declined. UK, France and Ireland implemented plain packaging in May this year and many other countries are to follow suit. This shows that with consented effort, advocacy work on plain tobacco packaging can win good results. I am not smoking my way to the grave. Are you?